Pediatric Urology

Conditions treated in children

Circumcision

Hypospadias

Testis Absent/Undescended/Torsion of Testis

Neurogenic bladder

Nocturnal Enuresis

Urinary Tract Infection

Hydrocele & Hernia

Antenatal Hydronephrosis

Circumcision:

Surgical removal of excessive long prepusial skin. Child may have complained of ballooning of prepusial skin, crying while urination or recurrent U.T.I. and on Examination found to have in ability to retract prepusial skin, Procedure is performed under anaesthesia and requires one day stay /day care.

Hypospadias:

Is a birth defect in boy where urethral opening is in abnormal position instead of at tip of penis.There could be bending of penis alongwith (chordee).

It requires surgical correction depending upon location of meatus and (chordee)- stages of surgery is decided i.e. it may require one and two or sometime more stage surgeries. Surgery can be performed after one year of age.

Disease of testis:

In normal male child-both testis should be in scrotal sac, but sometime it could be in abnormal position i.e. in groin/intra-abdominal.

If it doesn't reach in to scrotum by 6 months, it requires surgical procedure to bring it down so it does not get damage because of an abnormal environment as well to prevent / recognise certain complications earlierlike torsion / malignancy.

Torsion of testis:

Sometimes Testis is having long Mesentery,hanging freely it can get rotation of 180 / 360 degree and child develop sudden excruciating pain which is an emergency condition – where after diagnostic test (USG Doppler) it may require surgical correction in form of un-twisting and fixation, along with contralateral fixation as well.

Neurogenic bladder:

Patients with Neurogenic bladder may have abnormal urinary voiding complains, incontinence of urine or recurrent urinary tract infection even sometime patient can develop renal failure also. Apart from routine investigations, urodynamic study would be of help.

This kind of problems usually arise from spinal cord problems like Meningomyelocele, Spina bifida etc.

Usually it is treated by conservative treatment with medications or sometime with self-catheterization (CIC)

Nocturnal enuresis (bed-wetting):

This is commonest urological problem seen in children.

Approximate 10 to 20% of children between the age of 5 to 6 years are having this problem

In rarecases, it may persist upto age of 15 years, if it persists more than this age then requires thorough evaluation.

If it is only nocturnal incontinence, usually it does not require detailed investigation,

If child is having episode of urinary tract infection particularly associated with fever, requires detailed evaluation in the form of routine blood / urine analysis, ultra-sonography and if requires Micturating Cysto-Urethrogram (VCUG).